Psypath: behaviorist appr. to treating phobias AO1+3 Flashcards
Both based on which principle?
Counter-conditioning: new response to phobic stimulus learned by pairing w/relaxation, not anxiety
reciprocal inhibition?
Patients respond to a feared stimuli w/relaxation, not anxiety
fear + relaxation can’t co-exist
Anxiety hierarchy
client + therapist design list/hierarchy of frightening/stressful events/objects
Relaxation
Client taught deep muscle relaxation
Impossible to be afraid+ be relaxed at the same time
Involves breathing exercises/meditation/mental imagery
Can involve drugs (e.g. valium) or hypnosis
Gradual exposure
Helps client work up hierarchy while maintaining deep relaxation
How do flooding + systematic desensitisation (SD) differ?
Flooding-> exposing phobic patients to fear w/out gradual build-up in anxiety hierarchy
Immediate exposure to frightening situation- prevents avoidance
What does flooding stop a pt doing?
avoidance
how many sessions needed?
1 session can last 2/3 hrs
1 session can be all needed
how does flooding work?
Stops phobic responses quickly: prevents avoidance behaviour, pt learns phobic stimulus is harmless (extinction in CC)
Learned response extinguished when conditioned stimulus (e.g. dog) is encountered w/out learned fear response (CR) association w/the UCS is broken: CS no longer produces CR (fear)
Pts can achieve relaxation- they are exhausted by fear response from immediate exposure
Strength SD -> supportive empirical ev. to demonstrate effectiveness
E-McGrath et al (2009)- 75% of patients w/phobias responded to SD- most effective due to the in vivo techniques (actual contact w/fear stimulus more effective than imagery-based techniques).
E-Gilroy et al (1990) examined 42 patients w/arachnophobia using 3x 45 min sessions- found reduced fear 33 months later, compared to a control group (relaxation techniques only)
L- empirical ev. increases treatment validity to overcome phobias
Strength SD -> preferred as a treatment for phobias by patients to flooding
E- doesn’t cause same lvls of distress w/ immediate prestation of ear-inducing stimulus- low attrition rates
E- considered more appropriate treatment for pts w/ severe anxiety disorders- learning relaxation techniques can be a positive + pleasant experience
L- SD may be seen as more ethical treatment for these patients
Strength SD-> used to help pts who can’t access other treatments, e.g. pts w/learning disabilities
E- ppl requiring treatment for phobias have learning disabilities, but main alternatives to SD = unsuitable.
Ppl w/learning disabilities struggle w/cognitive therapies requiring complex, rational thought
E- may feel confused/distressed by traumatic experience of flooding
L- SD = most appropriate treatment for ppl w/learning disabilities + phobias
Strength SD-> used w/ VR, not irl
E- exposure through VR used to avoid dangerous situations (e.g. heights), cost-effective as psychologist + pts don’t have to leave consulting room
E- but, has evidence to suggest VR exposure = less effective than real exposure for social phobias, lacks realism (Wescler et al. 2019)
L- means advantages of VR based SD could be suitable for some, not all, phobias
Limitation SD -> not effective in treating all phobias
E- pts w/phobias not developed through a personal experience (CC), e.g. fear of snakes, not effectively treated using SD, can’t be that their phobia has been learnt + can’t be unlearnt
E- some psychologists say certain phobias have evolutionary survival benefits + are not a result of learning
L- limitation of SD, ineffective in treating evolutionary phobias w/ an innate bias
Strength flooding -> as effective as other treatments + most cost effective
E- Ougrin (2011) compared flooding-cognitive therapies: flooding is effective + quicker than others
Quick effect= strength, pts free of symptoms asap- treatment = cost-effective
E- has implications for economy, could reduce financial burden on NHS- offering a quicker + cheaper treatment for phobics
L- flooding can be useful + could be first type of treatment for NHS patients
Limit flooding -> not suitable for all, v. traumatic
E- Schumacher (2015) found patients + therapists rated flooding as more stressful than SD
Problem ≠ flooding is unethical (pts give informed consent) but are unwilling to see it through- can be distressing
E- intensity of experience can lead to high attrition rates (ppl drop out) + can make phobia even worse if treatment is not completed
L- shows individual differences can be limitation of effectiveness of flooding as treatment for phobias
Limit flooding -> inappropriate for phobias needing high lvls of cognition (soc. phobias)
E- e.g. sufferer of a social phobia experiences an anxiety response + thinks unpleasant thoughts abt the social situation
E- mb more beneficial for more complex phobias to be treated w/cognitive therapies bc therapies tackle irrational thinking
L- whilst flooding mb appropriate in some situations, it may not be useful for all phobias + reduces usefulness as a treatment
How does behavioral appr. to treating phobias link to reductionism?
- Behavioral exp. mb too simplistic in reducing complex behaviour to simple S-R association
- Ignores role of cognition: phobias mb bc of irrational thinking
How does behavioral appr. to treating phobias link to determinism?
- Ignores role of free will in formation of phobias, implying envir. determinism
- Not every1 bitten by a dog develops fear of them: other processes must be involved
How does behavioral appr. to treating phobias link to nomothetic/idiopathic?
- Suggests nomothetic approach, implying universal laws
- But if individual cognition plays a part, a more idiographic approach mb preferred
counter-conditioning
new response from phobic stimulus learned by pairing w/relaxation not anxiety
systematic desensitisation
pts respond to feared stimulus w/relaxation not anxiety
anxiety hierarchy
list including stressful objects/events
reciprocal inhibition
can’t experience fear + be relaxed at same time/simultaneously
extinction
pts quickly learn phobic stimulus=harmless
flooding
stopping phobic responses quickly
McGrath et al (1990)
75% of pt w/phobias responded to SD- more effective in vivo techniques than in imagery-based techniques
Gilroy et al (1990)
Examined 42 patients w/arachnophobia using 3x 45 min sessions- found reduced fear 33 months later, compared to a control group (relaxation techniques).
Weschler et al (1990)
VR exposure may be less effective than real social phobia exposure- lacks realism.
Ougrin et al (2011)
Compared flooding to other cognitive therapies- found it is highly effective + quicker than alternatives- pts are free of symptoms asap.
Schumacher et al (2015)
Pts + therapists rated flooding more stressful than SD- patients unwilling to finish- can be very distressing.
